CATARACTS

What is a cataract?
A cataract is a clouding of the naturally clear lens of the eye.  After light passes through the clear cornea, the lens focuses light rays on the retina like a camera lens focuses light on the film or sensor in a digital camera to produce a focused image.  Clouding of the clear lens prevents the light rays from passing easily resulting in an image that is blurry, distorted, hazy  or cloudy.

 

What causes cataracts?

Cataracts usually develop as part of the aging process, but they can also come from:

Eye injuries or Trauma
Certain diseases such as Diabetes
 Medications (steroids)
 Genetic inheritance

Excessive Sun exposure

Poor nutrition

How can a Cataract be Treated in Las Vegas?
The cataract may need no treatment at all if the patient is not impaired and can perform all his/her normal activities.  Sometimes a change in your eyeglass prescription may improve vision temporarily.  It is often advisable to seek a second opinion as some cataract surgeries may not be medically necessary.

There are no medications, eye drops, exercises, or glasses that will cause cataracts to disappear once they have formed. When you are not able to see well enough to do the things you like to do, cataract surgery should be considered. Surgery is the only way to remove a cataract.  Modern cataract surgery uses ultrasound with or without lasers to remove the cataract.  The laser is the latest advance but many surgeons believe that it fails to achieve any significant benefit for the increased out of pocket cost required from the patient.

Cataracts can not be completely removed with a laser, but lasers can be used to correct astigmatism and to create a reproducible surgical incision.   Many surgeons believe that the wound created by a laser is suboptimal and tends to leak and have chosen to only use the laser to create an opening in the lens and astigmatism correction.   It is important to realize that surgeons are not allowed to charge extra just for using a laser, and if you are asked for more money and your surgeon cannot explain to your satisfaction what benefit you are likely to achieve by using the laser, you should consider a second opinion.   The jury is out and many skilled surgeons believe that the laser offers no benefit.

In cataract surgery, the cloudy lens is fragmented with ultrasound and or the laser and is removed from a small incision in the eye (generally less than 1/4 of an inch!). In modern cataract surgery the focusing power of the natural lens is restored by replacing it with a permanent intraocular lens implant.  Modern lens implants can actually correct near, distance and intermediate vision!

These special or “premium” lenses are generally not covered by insurance carriers.  It is important to ask the doctor’s staff if your insurance will cover this advanced technology and if not what the fee will be.   Financing is available for premium lens implants and for all goods and services at the Southwest Eye Institute and Dr. Malitz is among the most experienced surgeons with advanced technology implants in the country!

What can I expect if I decide to have CATARACT Surgery?

Before Cataract Surgery

When you and your ophthalmologist (medical eye doctor) have decided that it is time to have your cataract removed, be sure to mention any special medical risks you may have. Ask your eye doctor if you should continue your usual medications.  Normally you should take your medications with a sip of water.  There may be exceptions with diabetic medications.

Your eye will be measured with ultrasound or an IOL Master to determine the proper power of the intraocular lens (IOL) that will be placed in your eye during surgery.

The Day of Cataract Surgery

Cataract Surgery is done on an outpatient basis. You may be asked to skip breakfast, depending on the time of your surgery. Upon arrival for cataract surgery, you will be given eyedrops, and perhaps medications to help you relax.

A local anesthetic will make the cataract operation virtually painless. Though you may see light and movement, you will not be able to see the surgery while it is happening and will not have to worry about keeping your eye open or closed.

The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your head. When the operation is over, modern cataract surgery techniques do not require stitches or patches.  the cataract surgeon or nurse will instruct you to place a shield over your eye while sleeping to protect your eye.

After a short stay in the outpatient recovery area, you will be ready to go home. Plan to have someone else drive you home.

Following Cataract Surgery

You will need to:

Use the eyedrops as prescribed (you will have three, an antibiotic, a steroid and a non steroidal anti inflamatory drop unless you opt for the “dropless” technique.  With this technique, the medication is introduced to the eye at the end of surgery and this reduces or eliminates the cost and burden of instilling drops after surgery.

If you are not allergic to sulfa medications, you may be prescribed pills to control the eye pressure.
Be careful not to rub or press on your eye
Use over-the-counter pain medicine, like Advil or Tylenol if necessary
You may bend, lift and strain and resume your normal activities right after modern cataract surgery.
Continue normal daily activities and moderate exercise
Ask your cataract doctor when you can begin driving
Wear eyeglasses or shield as advised by your eye doctor

How is the CATARACTSurgery Done?
Under an operating microscope, a small incision (less than 1/4 of an inch!) is made into the eye. Microsurgical instruments are used to fragment and suction the CATARACTOUS lens from the eye. The back membrane of the cataract (called the posterior capsule) is left in place.

A plastic intraocular lens implant will be placed inside the eye to replace the natural lens that was removed.

When is the Laser used?
Recently the cataract laser was approved by the FDA for aiding in the accuracy of CATARACT surgery.  The posterior capsule sometimes turns cloudy several months or years after the original cataract operation. If this blurs your vision, a clear opening can be made painlessly in the center of the membrane with a laser. Laser surgery is never part of the original cataract operation.

Will Cataract Surgery Improve my Vision?
Over 98% of cataract surgeries improve vision, but a small number of patients may have problems.  If you have underlying retinal damage from Macular Degeneration or Diabetes, you may not achieve excellent vision.

CATARACT Complications 
Infection, bleeding and swelling, or detachment of the retina or even loss of vision or the eye are some of the more serious complications that may affect your vision after cataract surgery.  Fortunately complication are uncommon with cataract surgery.

Call you eye doctor immediately if you have any of the following symptoms after surgery:

Pain not relieved by non-prescription pain medication
Loss of vision
Nausea, vomiting, or excessive coughing
Injury to the eye
Swelling of the eyelids or discharge
Pre-existing conditions

Even if the cataract surgery is successful, the eye may still not see as well as you would like. Other problems with the eye, such as macular degeneration (aging of the retina), glaucoma, and diabetic damage may limit vision after surgery. Even with such problems, cataract surgery may still be worthwhile.

If the eye is healthy, the chances are excellent that you will have good vision following removal of your cataract.